Best evidence summary of dietary management during chemotherapy in children with acute lymphoblastic leukemia

This study aims to systematically retrieve, appraise, and synthesize the best available evidence on dietary management during chemotherapy in children with acute lymphoblastic leukemia (ALL), and to inform the development of individualized, evidence-based dietary management strategies.

A comprehensive search was conducted in guideline repositories and databases, including BMJ Best Practice, UpToDate, the Scottish Intercollegiate Guidelines Network, the Guidelines International Network, the Cochrane Library, China National Knowledge Infrastructure, and Medlive. The search covered all records from database inception to December 22, 2024. Two reviewers independently performed literature screening, quality appraisal, and evidence extraction.

A total of 13 publications were included, comprising 2 clinical decision resources, 4 guidelines, 4 expert consensus statements, and 3 systematic reviews. Thirty-one evidence statements were synthesized across nine domains: goals of dietary management, nutritional assessment and risk screening, weight management, nutrient intake and food preparation, dietary structure, eating patterns and restrictions, physical activity, management of chemotherapy-related side effects, and multidisciplinary collaboration and education.

This study synthesizes the best available evidence on dietary management during chemotherapy in children with ALL. The findings provide a structured foundation for developing standardized and individualized dietary management strategies, encompassing nutritional assessment, dietary guidance, and management of treatment-related adverse effects. Health care professionals are encouraged to apply this evidence in a patient-centered manner, taking into account clinical context and individual patient needs.

This study was registered at the Fudan University Center for Evidence-Based Nursing (Registration No. ES20246866).